NPIMap

Individual provider Active NPI

Denise O. Legg Braverlly, LIMHP

  • Professional Counselor
  • Omaha, NE
National Provider Identifier
1003240169
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1377 Issued in NE
Practice address
11414 W Center Rd Ste 314
Omaha, NE 68144-4420
Phone
(402) 960-6861
NPI assigned
Aug 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4474 NE
Professional Counselor 101YP2500X
Professional Counselor 101YP2500X 2178 NE
Professional Counselor 101YP2500X 1377 NE Primary

Addresses

Primary practice location

11414 W Center Rd Ste 314
Omaha, NE 68144-4420

Mailing address

11414 W Center Rd Ste 314
Omaha, NE 68144-4420
Phone (402) 639-2901

Other names 1

  • Denise O. Parks Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1377NEMDAddiction (Substance Use Disorder) Counselor
2178NEMDChiropractor
4474NEMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Hope and Wellness Center Professional Past Accepting new patients
Icare Counseling Mental Health Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1003240169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11414 W CENTER RD STE 314",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681444420",
            "telephone_number": "402-639-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11414 W CENTER RD STE 314",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681444420",
            "telephone_number": "402-960-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGG BRAVERLLY",
        "first_name": "DENISE",
        "middle_name": "O.",
        "name_prefix": "Mrs.",
        "credential": "LIMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-26",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "4474",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "2178",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "1377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "PARKS",
            "middle_name": "O.",
            "credential": "LIMHP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.